Mechanisms of Slow Flow/No Reflow Phenomena and How to Deal With

Slow flow and no reflow are often confused in clinical practice, but they are completely different phenomena. No reflow is a reperfusion injury that occurs mainly in patients with acute myocardial infarction, in which myocardial blood flow to the infarcted area fails despite revascularization of the infarcted-related lesion. Since capillaries are structurally destroyed along with myocardial necrosis and capillaries are compressed due to myocardial edema, blood flow from small arteries to capillaries to small veins is blocked. As a result, the blood flow velocity at the epicardial surface of the coronary artery is reduced, resulting in contrast delay in coronary angiography.